Wisconsin
Provider Communications

Articles Category: State & Federal

Title Publication Category Date

Keep up with Medicaid News - May 2022

- AIM Specialty Health Outpatient Rehabilitative and Habilitative Services Clinical Appropriateness Guidelines updates
- Prior authorization requirement change for HCPCS code K1022
- New specialty pharmacy medical step therapy requirements-March 2022
May 2022 Anthem Provider News - Wisconsin Medicaid May 1, 2022

Screening for alcohol use disorder in high-prevalence demographics

May 2022 Anthem Provider News - Wisconsin Medicaid May 1, 2022

Keep up with Medicare News - May 2022

- Anthem expands specialty pharmacy precertification list-March 2022 update
- Anthem expands specialty pharmacy precertification list-April 2022 update
- New specialty pharmacy medical step therapy requirements-May 2022 update
May 2022 Anthem Provider News - Wisconsin Medicare May 1, 2022

Convenient, reliable at-home testing for colorectal cancer and diabetes care

May 2022 Anthem Provider News - Wisconsin Medicare May 1, 2022

HEDIS 2022: summary of changes from NCQA

May 2022 Anthem Provider News - Wisconsin Medicare May 1, 2022

New specialty pharmacy medical step therapy requirements-March 2022 update

May 2022 Anthem Provider News - Wisconsin Medicare May 1, 2022

CORRECTION: Save time tomorrow by using CPT II codes today: Introducing the FEP Quality Reimbursement Program for PPO providers

May 2022 Anthem Provider News - Wisconsin Federal Employee Plan (FEP) May 1, 2022

Join us for an FEP Quality Learning Program live webinar

May 2022 Anthem Provider News - Wisconsin Federal Employee Plan (FEP) May 1, 2022

The Anthem, Inc. name is changing

April 2022 Anthem Provider News - Wisconsin Medicaid Apr 1, 2022

Keep up with Medicaid News - April 2022

- Medical policies and clinical utilization management guidelines update
- Phone number change for AIM in Wisconsin
- Medical drug benefit clinical criteria updates
- Specialty pharmacy site of care program retraction
- Prior authorization updates for medications billed under the medical benefit
April 2022 Anthem Provider News - Wisconsin Medicaid Apr 1, 2022

Reimbursement policy update: Inpatient readmissions

April 2022 Anthem Provider News - Wisconsin Medicaid Apr 1, 2022

Disease Management/Population Health program

April 2022 Anthem Provider News - Wisconsin Medicaid Apr 1, 2022

Clinical Criteria updates

April 2022 Anthem Provider News - Wisconsin Medicaid Apr 1, 2022

Evaluation and management documentation guidelines

April 2022 Anthem Provider News - Wisconsin Medicaid Apr 1, 2022

Save time by using CPT II codes: Introducing FEP Quality Reimbursement Program for PPO providers

April 2022 Anthem Provider News - Wisconsin Federal Employee Plan (FEP) Apr 1, 2022

The Anthem, Inc. name is changing

April 2022 Anthem Provider News - Wisconsin Medicare Apr 1, 2022

Keep up with Medicare News - April 2022

- Medical Policies and Clinical Utilization Management Guidelines update
- AIM Specialty Health Outpatient Rehabilitative and Habilitative Services Clinical Appropriateness Guidelines updates
- Anthem expands specialty pharmacy precertification list
April 2022 Anthem Provider News - Wisconsin Medicare Apr 1, 2022

Implementation update for the NYC Medicare Advantage Plus plan, an alliance between Empire BlueCross BlueShield and EmblemHealth

April 2022 Anthem Provider News - Wisconsin Medicare Apr 1, 2022

Reimbursement policy update: Inpatient readmissions

April 2022 Anthem Provider News - Wisconsin Medicare Apr 1, 2022

The impact of listening

April 2022 Anthem Provider News - Wisconsin Medicare Apr 1, 2022

Clinical Criteria updates

April 2022 Anthem Provider News - Wisconsin Medicare Apr 1, 2022

Evaluation and management documentation guidelines

April 2022 Anthem Provider News - Wisconsin Medicare Apr 1, 2022

Model of Care required training

April 2022 Anthem Provider News - Wisconsin Medicare Apr 1, 2022

Implementation update for the NYC Medicare Advantage Plus plan, an alliance between Empire BlueCross BlueShield and EmblemHealth

City of New York Retirees will NOT transition to NYC Medicare Advantage Plus on April 1, 2022. Additional updates on a new effective date will be made available at a later date. Read important information about this change here.
Transition to NYC Medicare Advantage Plus Delayed - Wisconsin Medicare Mar 15, 2022

Change to the Federal Employee Program clinical grievance and appeal address

March 2022 Anthem Provider News - Wisconsin Federal Employee Plan (FEP) Mar 1, 2022

It is CAHPS survey time!

March 2022 Anthem Provider News - Wisconsin Medicaid Mar 1, 2022

Evaluation and management services correct coding reminder (professional)

March 2022 Anthem Provider News - Wisconsin Medicaid Mar 1, 2022

Urinary tract infection toolkits are on the way

March 2022 Anthem Provider News - Wisconsin Medicaid Mar 1, 2022

Keep up with Medicare News - March 2022

- Medical step therapy updates
- Phone number change for AIM in Wisconsin
March 2022 Anthem Provider News - Wisconsin Medicare Mar 1, 2022

HEDIS 2022 Federal Employee Program medical record request requirements

March 2022 Anthem Provider News - Wisconsin Federal Employee Plan (FEP) Mar 1, 2022

Annual wellness visits for Medicare Advantage members

March 2022 Anthem Provider News - Wisconsin Medicare Mar 1, 2022

Pharmacy: Medication adherence

March 2022 Anthem Provider News - Wisconsin Medicare Mar 1, 2022

Evaluation and management services correct coding reminder (professional)

March 2022 Anthem Provider News - Wisconsin Medicare Mar 1, 2022

Clinical criteria updates

March 2022 Anthem Provider News - Wisconsin Medicare Mar 1, 2022

Provider notification for utilization management authorization rule operations workgroup item 2662

March 2022 Anthem Provider News - Wisconsin Medicare Mar 1, 2022

Keep up with Medicaid News - February 2022

- Prior authorization updates for medications billed under the medical benefit
February 2022 Anthem Provider News - Wisconsin Medicaid Feb 1, 2022

Get faster payments with EFT

February 2022 Anthem Provider News - Wisconsin Medicaid Feb 1, 2022

2021 CAHPS survey results

February 2022 Anthem Provider News - Wisconsin Medicaid Feb 1, 2022

Cancer Care Navigator

February 2022 Anthem Provider News - Wisconsin Medicaid Feb 1, 2022

Keep up with Medicare News - February 2022

- NYC Medicare Advantage Plus update
February 2022 Anthem Provider News - Wisconsin Medicare Feb 1, 2022

School District of West Allis West Milwaukee offers Medicare Advantage option to retirees

February 2022 Anthem Provider News - Wisconsin Medicare Feb 1, 2022

Get faster payments with EFT

February 2022 Anthem Provider News - Wisconsin Medicare Feb 1, 2022

Submitting prior authorizations is getting easier

January 2022 Anthem Provider News - Wisconsin Medicare Jan 1, 2022

2022 FEP benefit information available online

January 2022 Anthem Provider News - Wisconsin Federal Employee Plan (FEP) Jan 1, 2022

Keep up with Medicaid News - January 2022

- AIM Specialty Health Radiation Oncology Clinical Appropriateness Guidelines updates
- Specialty pharmacy site of care
- Prior authorization updates for medications billed under the medical benefit
January 2022 Anthem Provider News - Wisconsin Medicaid Jan 1, 2022

The Behavioral Health Areas of Expertise Profile improves the referral process

January 2022 Anthem Provider News - Wisconsin Medicaid Jan 1, 2022

Botox update for Anthem members

January 2022 Anthem Provider News - Wisconsin Medicaid Jan 1, 2022

Reducing the burden of medical record review and improving health outcomes with HEDIS ECDS reporting

January 2022 Anthem Provider News - Wisconsin Medicaid Jan 1, 2022

Submitting prior authorizations is getting easier

January 2022 Anthem Provider News - Wisconsin Medicaid Jan 1, 2022

Keep up with Medicare News - January 2022

- AIM Specialty Health Radiation Oncology Clinical Appropriateness Guidelines update
- Medical step therapy updates
- Anthem expands specialty pharmacy precertification list
January 2022 Anthem Provider News - Wisconsin Medicare Jan 1, 2022

Important update on Botox® for Anthem Medicare members

January 2022 Anthem Provider News - Wisconsin Medicare Jan 1, 2022

Reducing the burden of medical record review and improving health outcomes with HEDIS ECDS reporting

January 2022 Anthem Provider News - Wisconsin Medicare Jan 1, 2022

Keep up with Medicaid News - December 2021

  • Durable medical equipment prior authorization requirement changes effective December 1, 2021
  • Updates to AIM Specialty Health musculoskeletal interventional pain management clinical appropriateness guideline
  • Medical drug benefit Clinical Criteria updates
  • Updates to AIM Specialty Health Cardiology Clinical Appropriateness Guidelines
December 2021 Anthem Provider News - Wisconsin Medicaid Dec 1, 2021

Medical policies and clinical utilization management guidelines update

December 2021 Anthem Provider News - Wisconsin Medicaid Dec 1, 2021

Prior authorization requirement changes effective December 1, 2021

December 2021 Anthem Provider News - Wisconsin Medicaid Dec 1, 2021

Updates to AIM Specialty Health Advanced Imaging Clinical Appropriateness Guidelines

December 2021 Anthem Provider News - Wisconsin Medicaid Dec 1, 2021

Reimbursement policy update: Drug screen testing

December 2021 Anthem Provider News - Wisconsin Medicaid Dec 1, 2021

Good news: Non-payment remittance advice enhancements are here

December 2021 Anthem Provider News - Wisconsin Medicaid Dec 1, 2021

HEDIS measures: Follow-Up After ED Visits for Mental Illness and Alcohol and Other Drug Abuse or Dependence

December 2021 Anthem Provider News - Wisconsin Medicaid Dec 1, 2021

2022 Medicare Advantage service area and benefit updates

December 2021 Anthem Provider News - Wisconsin Medicare Dec 1, 2021

Keep up with Medicare News - December 2021

  • Updates to AIM Specialty Health musculoskeletal interventional pain management clinical appropriateness guideline
  • Medical drug benefit clinical criteria updates
  • Protocol for providers serving members with hearing aid coverage administered by Hearing Care Solutions
  • New York City Medicare Advantage announcement
  • Medical policies and clinical utilization management guidelines update
  • Updates to AIM Specialty Health Cardiology Clinical Appropriateness Guidelines (WI only)
December 2021 Anthem Provider News - Wisconsin Medicare Dec 1, 2021

Adjudicating claims for COVID-19 vaccines, their administration and COVID-19 monoclonal antibodies

December 2021 Anthem Provider News - Wisconsin Medicare Dec 1, 2021

Updates to AIM Specialty Health Advanced Imaging Clinical Appropriateness Guidelines

December 2021 Anthem Provider News - Wisconsin Medicare Dec 1, 2021

Reimbursement policy update: Drug screen testing

December 2021 Anthem Provider News - Wisconsin Medicare Dec 1, 2021

Good news: Non-payment remittance advice enhancements are here

December 2021 Anthem Provider News - Wisconsin Medicare Dec 1, 2021

Somatus is your resource for kidney care management

December 2021 Anthem Provider News - Wisconsin Medicare Dec 1, 2021

Keep up with Medicare News - November 2021

View these Medicare articles:
- Anthem expands specialty pharmacy prior authorization list
November 2021 Anthem Provider News - Wisconsin Medicare Nov 1, 2021

Anthem offering Advance Medical Directives program for 2022

November 2021 Anthem Provider News - Wisconsin Medicare Nov 1, 2021

Updates to AIM Specialty Health Cardiology Clinical Appropriateness Guidelines

November 2021 Anthem Provider News - Wisconsin Medicare Nov 1, 2021

New York City Medicare Advantage announcement

November 2021 Anthem Provider News - Wisconsin Medicare Nov 1, 2021

Clinical criteria updates

November 2021 Anthem Provider News - Wisconsin Medicare Nov 1, 2021

Electronic data interchange process

November 2021 Anthem Provider News - Wisconsin Medicare Nov 1, 2021

Keep up with Medicaid News - November 2021

View these Medicaid articles:
- Prior authorization updates for specialty pharmacy
November 2021 Anthem Provider News - Wisconsin Medicaid Nov 1, 2021

Electronic data interchange process

November 2021 Anthem Provider News - Wisconsin Medicaid Nov 1, 2021

Claims editing update for ICD-10-CM Excludes1 notes

November 2021 Anthem Provider News - Wisconsin Medicaid Nov 1, 2021

Clinical criteria updates

November 2021 Anthem Provider News - Wisconsin Medicaid Nov 1, 2021

Unspecified diagnosis reminder

November 2021 Anthem Provider News - Wisconsin Medicaid Nov 1, 2021

Reimbursement policy update: Corrected claims

November 2021 Anthem Provider News - Wisconsin Medicaid Nov 1, 2021

4 things you can do to encourage cancer screenings for your female patients

November 2021 Anthem Provider News - Wisconsin Medicaid Nov 1, 2021

New Medicare Advantage plan will have access to BlueCross BlueShield Medicare Advantage PPO Network Sharing providers nationally

Effective January 1, 2022, approximately 240,000 Medicare-eligible City of New York retirees across the United States will transition to Retiree Health Alliance’s NYC Medicare Advantage Plus plan and have access to BlueCross BlueShield Medicare Advantage PPO Network Sharing. Read important information about this change in the New York City Medicare Advantage announcement.

New 240k member Medicare Advantage Group Retiree PPO plan Medicare Oct 19, 2021

Keep up with Medicaid News - October 2021

View these Medicaid articles:
- 2021 affirmative statement concerning utilization management decisions
- May 2021 medical policies and utilization management guidelines update
October 2021 Anthem Provider News - Wisconsin Medicaid Oct 1, 2021

Diabetes testing and screening HEDIS measures

October 2021 Anthem Provider News - Wisconsin Medicaid Oct 1, 2021

Get your payments faster when you sign up for electronic funds transfer

October 2021 Anthem Provider News - Wisconsin Medicaid Oct 1, 2021

New reimbursement policy: Sexually transmitted infections testing (Professional)

October 2021 Anthem Provider News - Wisconsin Medicaid Oct 1, 2021

Prior authorization updates for specialty pharmacy

October 2021 Anthem Provider News - Wisconsin Medicaid Oct 1, 2021

Get your payments faster when you sign up for electronic funds transfer

October 2021 Anthem Provider News - Wisconsin Medicare Oct 1, 2021

Keep up with Medicare news - October 2021

View these Medicare articles:
- 2021 affirmative statement concerning utilization management decisions
- May 2021 Medical Policies and Utilization Management Guidelines update
October 2021 Anthem Provider News - Wisconsin Medicare Oct 1, 2021

New reimbursement policy: Sexually transmitted infections testing (Professional)

October 2021 Anthem Provider News - Wisconsin Medicare Oct 1, 2021

Information about 2021 Special Needs Plans

October 2021 Anthem Provider News - Wisconsin Medicare Oct 1, 2021

HEDIS medical record submission made easier with our Remote EMR Access Service

October 2021 Anthem Provider News - Wisconsin Medicare Oct 1, 2021

New medical step therapy requirements

October 2021 Anthem Provider News - Wisconsin Medicare Oct 1, 2021

Keep up with Medicaid news  - September 2021

View these Medicaid articles:
- Clinical Criteria Updates Notification – May 2021
- CT to detect coronary artery calcification — AIM transition
September 2021 Anthem Provider News - Wisconsin Medicaid Sep 1, 2021

Keep up with Medicare news - September 2021

View this Medicare article:
- Clinical criteria updates notification – May 2021

 

September 2021 Anthem Provider News - Wisconsin Medicare Sep 1, 2021

Reimbursement Policy Update: DRG Inpatient Facility Transfers

September 2021 Anthem Provider News - Wisconsin Medicare Sep 1, 2021

Utilization management authorization rule operations

September 2021 Anthem Provider News - Wisconsin Medicare Sep 1, 2021

Prior authorization form notification

September 2021 Anthem Provider News - Wisconsin Medicare Sep 1, 2021

Change in email submission of service requests for Federal Employee Program® members*

*Material Adverse Change (MAC)
August 2021 Anthem Provider News - Wisconsin Federal Employee Plan (FEP) Aug 1, 2021

Medicaid News - August 2021

View these Medicaid articles:
-Iron Infusion Step Therapy
-Prior authorization requirement changes effective September 1, 2021 – UM AROW 1837
-Iron Infusion Prior Authorization Update
August 2021 Anthem Provider News - Wisconsin Medicaid Aug 1, 2021

Medicare News - August 2021

View these Medicare articles:
- Infliximab Step Therapy - Effective 7/15/2021
- Prior authorization requirement changes effective October 1, 2021 – UM AROW 1907
August 2021 Anthem Provider News - Wisconsin Medicare Aug 1, 2021

Preventing claims denials: Shingles vaccine

August 2021 Anthem Provider News - Wisconsin Medicare Aug 1, 2021
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